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Gesundheitliche Chancengleichheit und Kosten-Effektivität: Was sagen wichtige gesundheitspolitische Akteure zu diesem potentiellen Zielkonflikt?
Health inequalities and cost-effectiveness: What do important health policy actors say about this potential conflict situation?
Gesundheitswesen 77, 81-85 (2015)
The German statutory health-care system is based on the principle of solidarity and thus it is committed to the objective of 'equal chances'. From an economic perspective it is also important to emphasise that scarcity of resources continuously pushes the services towards cost control and towards increasing cost-effect-iveness. There could be conflicts between the 2 objectives 'equal chances' and 'cost-effectiveness', of course, for example if measures for increasing cost-effectiveness lead to increased financial burdens of the insured. To date it has not been studied if and how this potential conflict is discussed in Germany.In a first step we searched for German publications discussing this potential conflict focusing on 3 major public health journals (Das Gesundheitswesen, Bundesgesundheitsblatt, Ethik in der Medizin) and on the internet portal "gerechte-gesundheit.de". For the main part of the paper, we looked for publications from 4 major health policy actors (Bundesärztekammer, Zentrale Ethikkommission bei der Bundesärztekammer, Deutscher Ethikrat, Sachverständigenrat zur Begutachtung der Entwicklung im Gesundheitswesen). All papers published since the year 2000 were included in the system-atic qualitative analysis.The analyses show that the potential conflict between 'equal chances' and 'cost-effectiveness' is rarely discussed in any detail, at most in an implicit way. It would be important, though, to have an explicit discussion, supported by scientifically based analyses and recommendations. One step towards this objective could be, for example, a closer cooperation between social-epidemiologists and health--economists.
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Publication type
Article: Journal article
Document type
Scientific Article
Keywords
Cost-effectiveness ; Health Inequalities ; Prioritization ; Trade-off
ISSN (print) / ISBN
0941-3790
e-ISSN
1439-4421
Journal
Gesundheitswesen, Das
Quellenangaben
Volume: 77,
Issue: 2,
Pages: 81-85
Publisher
Thieme
Non-patent literature
Publications
Reviewing status
Peer reviewed